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首页> 外文期刊>Journal of Nursing Education and Practice >Nursing students’ clinical judgment in high-fidelity simulation based learning: A quasi-experimental study
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Nursing students’ clinical judgment in high-fidelity simulation based learning: A quasi-experimental study

机译：基于高逼真度模拟学习的护理学生的临床判断：一项准实验研究

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Background: Improving students’ decision making and judgment skills becomes an essential part of nursing education. The purpose of this Quasi-experimental study was to assess nursing students’ clinical judgment in high-fidelity simulation based learning using observational measures. Method: Based on Tanner’s clinical judgment model, a single group repeated-measures design was used with a purposive sampling at one nursing school in Macao. A total of 113 baccalaureate nursing students (49 in year two, 64 in year three) completed five simulation sessions within a 36 hour period. Two tutors used the Clinical Judgment Rubric to assess students’ clinical judgment at the end of each simulation session. The inter-rater reliability for the sessions ranged from 0.833 to 0.910. Results: The scores for clinical judgment increased from the first simulation scenario to the last scenario. Compared with third-year students, second-year students had significantly higher scores of clinical judgment in scenarios two, three, four and five. The debriefing was essential to preparing students for improving their thinking and reasoning skills. Students perceived that simulation strengthened their theoretical knowledge and helped them to notice, interpret, and respond appropriately to contingencies and emergencies. Tutors’ comments indicated that second-year students valued the newly learned knowledge and used it to analyze the simulated scenarios while third-year students presented less knowledge and skill preparation. Conclusions: High-fidelity simulation using a computer-controlled human patient simulator has potential to support the development of clinical judgment in nursing students. Tutors are challenged to enhance students' intrinsic motivation for learning, and encourage them to continue their efforts in learning. Further research is needed to explore whether senior students have better performance in clinical judgment than junior students.
机译：背景：提高学生的决策和判断能力成为护理教育的重要组成部分。这项准实验性研究的目的是在使用观察性测度的基于高保真模拟的学习中评估护理学生的临床判断。方法：根据坦纳（Tanner）的临床判断模型，在澳门一所护理学校中采用单组重复测量设计并进行有目的抽样。总共113名学士学位护理学生（第二年49名，第三年64名）在36个小时内完成了五个模拟课程。每次模拟课程结束时，两名导师都使用“临床判断规则”来评估学生的临床判断。会话的评估者间可靠性介于0.833至0.910之间。结果：从第一个模拟方案到最后一个方案，临床判断分数都增加了。与三年级学生相比，二年级学生在第二，第三，第四和第五种情景中的临床判断分数明显更高。汇报对于提高学生的思维和推理能力至关重要。学生认为模拟可以增强他们的理论知识，并帮助他们注意到，解释和应对突发事件和紧急情况。老师的评论表明，二年级学生重视新学到的知识，并用它来分析模拟的情景，而三年级学生的知识和技能准备较少。结论：使用计算机控制的人类患者模拟器进行高保真模拟具有支持护理学生进行临床判断的潜力。挑战教师以增强学生学习的内在动力，并鼓励他们继续努力学习。需要进一步的研究来探索高年级学生在临床判断方面是否比初中生更好。

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